Within the United States, 35 million people are 65 years of age or older, and nearly 10 million of these live in rural communities where many experience profound disparities in their health care services. Nationwide, this is complicated by the fact that the percentage of older residents in rural communities is growing, due to younger people moving away for employment and retirees returning to smaller communities. An important goal of the Healthy People 2010 initiative is to reduce health disparities in vulnerable populations, including those from rural and minority ethnic backgrounds. Rural elders frequently experience barriers related to culture, history, language, economic status, educational level, and geographic isolation. Data concerning disparities related to rurality, aging, economic status, and culture are scarce, particularly regarding the perceptions of multicultural elders in the border region of southwestern New Mexico. Disparities are best analyzed in the context of elders' perceptions, values, priorities, and community resources. Consequently, the purpose of this study is to identify and analyze major health care issues and disparities for a group of rural elders, in their sociocultural contexts and from their perspective. The Specific Aims are: 1) To analyze definitive indicators of health care disparities for rural elders, and 2) To construct preliminary explanatory models based on definitions of health, operationalized indicators of disparities, and issues identified by rural elders. This critical ethnographic study will include ethnographic interviews, demographic data collection, participant observation, archival data review, consultation with key community members, field notes/reflective journal, and photography. Data will be analyzed using coding/thematic analysis, matrix analysis, and reflexive interaction between the principal investigator and key community consultants. Findings will address national rural health priorities by deepening the knowledge base concerning culturally congruent approaches to health disparities of rural elders and provide needed data for New Mexico through comparison of elders' health issues in the southwest to those elsewhere.